Docs should know about kids and alternative medicine

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Doctors and parents should talk about kids' use of alternative therapies, a study says.

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Use of complementary and alternative medicine is common among kids, a study finds

Parents should speak to pediatricians about complementary medicine

Communication can avoid any potential harmful interactions with conventional treatments

Your child's pediatrician isn't likely to ask whether you are giving your youngsters herbs or treating them to acupuncture.

But enough children are now using alternative therapies that physicians should be inquiring about it, and parents need to volunteer information about any complementary medicine approaches their children are using to avoid any potential harmful interactions with conventional treatments.

A new study published in the journal Pediatrics finds that the use of complementary and alternative medicine, or CAM, is common among children, especially those who have been diagnosed with chronic health conditions such as asthma.

In the analysis, researchers asked 926 Canadian parents at two children's hospitals about their CAM use; half said their children had used the therapies at the same time they were taking conventional drugs, while 10% tried alternative therapies before turning to conventional treatments and 5% used CAM in place of conventional medicine.

Yet many parents weren't telling pediatricians that their children were using CAM, which could increase the possibility of dangerous interactions.

The most commonly used CAM therapies included massage, faith healing, chiropractic and aromatherapy, while the most popular products to treat conditions ranging from cancer to asthma and inflammatory bowel disease were vitamins and minerals, herbal remedies and homeopathic medicines.

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"Whether we're looking at the general population or at children's hospitals, it seems that complementary medicine use is extremely common," says Dr. Sunita Vohra, lead author of the study and a pediatrician who is chair of the section on integrated medicine for the American Academy of Pediatrics.

In the United States, a recent survey found that one in nine children had used alternative therapies to treat a health condition.

Vohra says parents' own beliefs about and reliance on CAM therapies is a major factor behind its use in children, as is parents' desire to provide their children with every possible health option.

"For most parents, their number one priority is the health of their children so they're interested in exploring all options to promote their children's health," says Vohra. "Many parents consider all products that are available and seek out not only conventional health care but also complementary health care."

With CAM being used by so many children, however, she and her colleagues say it's time for pediatricians to do a better job of discussing the safety and efficacy of the therapies with parents.

"Given the rates of use, we would like to encourage all health care providers to ask about complementary therapies and we encourage all parents to tell," says Vohra. "In many cases, it's not discussed because parents think doctors won't support them, but it's far better to have an open discussion."

Such discussions can avoid potentially harmful interactions between conventional medicines and herbal remedies, for example, or other incompatibilities that can worsen, rather than improve, symptoms. In the study, parents reported 80 adverse effects, most of which were described as minor.

Most parents, says Vohra, will deny that their children are taking alternative therapies, even if they are -- and not because they want to intentionally deceive their doctors.

"They don't think of herbs as medicine," says Vohra. "So doctors should ask parents, 'What are all the therapies, including complementary medicines, that your child is taking?'"

Even if doctors and patients have more open discussions about alternative therapies, however, better knowledge about CAM approaches and their long-term effects is needed as well. That way, pediatricians can provide more scientifically based answers to questions about how safe and effective the therapies are.

"It's like asking if surgery effective," she says. "Would you do surgery for all things? No, you do it for some things."

In the meantime, studies are starting to suggest some areas in which CAM may be more effective than others.

For example, there is growing evidence that probiotics can reduce the incidence and mortality from NEC, a potentially fatal bowel disease that some premature infants develop. At the same time, studies are starting to show that probiotics are helpful in reducing diarrhea that can be a side effect of children taking antibiotics.

As knowledge about the benefits -- and risks -- of alternative therapies grows, Vohra hopes they can be better integrated into medical treatments rather than being an afterthought.